Declaration of Repair
(Please provide on your company letterhead)
Master: ________________
House: ________________
I, __________________________________ of _________________________________
do hereby declare that the goods listed on invoice number ___________________ were made in ________________________, were previously imported into the United States of America. Customs duties were paid upon import; the goods were re-exported to __________________ for repair and are now being returned back to us. The export value of the good s is __________________. The repair cost of the goods is _______________.
I further declare that no drawback claim has or with be made on said articles and no Customs certificate of manufacture and delivery has been made nor will be by us.
___________________________________
(Printed Name)
____________________________________
(Signature)
____________________________________ (Title and/or Dept)
____________________________________
(Date)
022011 SUPP (CRICCRC1) SUPERVISOR STANDARD AND DECLARATION FORM
022011 SUPP(CRI3) SUPERVISOR STANDARD AND DECLARATION FORM USE
1 IDENTIFICATION DE LA DECLARATION 11 CHANGEMENT
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